Donor Information (Part 1 of 2)

Person 1 First Name *

Person 1 Last Name *

Person 1 Email Address *

Person 2 First Name

Person 2 Last Name

Person 2 Email Address

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Address Line 2

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Home Phone (including Area Code)

Donation Information (Part 2 of 2)

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I wish this gift to be anonymous

Keddem is a 501(c)(3) nonprofit organization. Donations are tax-deductible to the extent allowed by law.
(Please note that PayPal will deduct a fee of approximately 3% of your contribution. Please consider increasing your gift to cover this fee.)

Is this gift for Refuah Shleimah (get well), or In Honor of , or In Memory of a loved? If so, please provide the following information:

Name of Person Being Remembered/Honored: